More hurtful psychiatry

I went to another appointment today, partly to get meds, partly to try to have some kind of useful session. I am in a shitty work environment now, and it’s bothering me, but I didn’t want to waste time talking about it because it is temporary, but he kept poking at that, and once again, ended up being hurtful – describing incidents I’ve discussed in the past with a totally different spin, missing the point of stories I’ve told in the past, etc. One example: I told about my first weeks as a doctor, being in the emergency alone with a terrible resident, and a very sick baby. I was terrified.

I had forgotten I had even discussed this with him. But today, he repeated the story to me, but rephrased it totally differently. “You were just as unhappy then, remember, talking about how there was such a critically ill baby, how thank God you were there to take care of it because everyone else was such an idiot.” Made me out a total narcissist. Believe me, I remember that night well, and I was terrified, not knowing what to do, worried that the resident knew even less than I and also didn’t recognize the seriousness of the situation. I certainly did not think, thank God I was there. In fact, I wished anyone else would have been there except me.

So I wonder – this is what he thinks of me? This is what he hears? It’s a long pattern of him hearing things that are irrelevant (I had forgotten the conversation entirely until he brought it up – it must have been months ago), and missing things that are critically important to me, such as, oh, my saying repeatedly that Cymbalta is making me have suicidal thoughts, wake up at 3 AM crying every day, etc.

I suppose I really should look around. For a woman. Closer to my life experience, more liberal, LCSW or MSW, not one of these dynamic type crap things. Or, once again, quit therapy altogether and go back to this plan. One thing I should not be doing is repeatedly going back and paying money for a situation that hurts me. Yet I do. Sort of like my career, my partner, and everything else in my life.



  1. I’m not convinced that having a woman psychiatrist is necessarily the answer to one’s problems – yours, I don’t know, but in general… I was with a female shrink for 2 years around the time that I was going through puberty, because I was fed up with my male shrink, but in the end, I went back to him because I felt the female was too gentle.

    Do you have someone amongst your medical friends who can give you a referral, or who can point you in the right direction – I realise it totally throws the confidentiality…

    I agree with your sentiment though – you shouldn’t be going back repeatedly if the situation is only hurting you = but more importantly, you should tell the shrink this straight up.

  2. I thnk that it’s the opposite. My great woman shrink was tough with me, and this guy is too gentle, sort of because I think he thinks women are fragile and all that. And I do tell him again and again, and he always manages to blame me for it. I said yesterday that I thought about what the good woman one would have said about this now to me if I had consulted her about whether or not to leave. “Look, every time, you come out feeling worse than you went in. You say he doesn’t respect you, doesn’t listen, basically misinterprets everything you say…why in the world do you keep going back to this bad situation, what is the payoff for you in this?” And she’d get me to either get over it or stop.

    I told him this, and he turned it around in a way that didn’t make any sense, saying that what the question should be is why I keep going and ruining any help he could be giving.

    Last night I dreamed I was at the end of a session and he did something inappropriate, like some professionality/ethics violation. Don’t know what it was, but I remember that it just gave me the push I needed to QUIT…and I was thankful. Because apparently, I am so fucked up that I can’t get out of a bad relationship even with a shrink. Gah.

    And no, no one I can really ask. I know at least three shrinks I’d go to, but knowing them makes it awkward. Too small community here.

  3. I have the name of one… head of a department – if you want his name and phone number, let me know… He’s north of you though.

  4. Don’t be afraid to change doctors….I just started seeing psychiatrists again, and I have been through quite a few. And also, just because he’s a doctor, doesn’t mean his opinion of you personally is any more qualifiied. He isn’t a trained psychoanalyist.

  5. actually, he is, which is most of the problem.

  6. Run away.

  7. Have you tried Cognitive-Behavioral Therapy? Or done a thorough screening through a site like There are good, caring, solid therapists out there who may not be miracle workers, but can be very helpful.

  8. CBT in the past was tremendously helpful. The problem is mostly where I live now, it’s very traditional and everyone is dynamically oriented if not a full on Freudian. There is almost no such thing as a LCSW or MSW or even psychology – they are even all PhD’s in very traditional dynamic schools. I am looking around for some other imports to the area…but since living here, I’ve seen maybe 5 practitioners for preliminary meetings, and all are very, “Tell me about what you remember of the womb.”

    Thanks for reinforcing what I felt to be unpopular, but right – that CBT is really more effective than the dynamic stuff, at least for someone like me without the gabillion issues. And thanks for stopping by.

  9. Hi Sara,
    This is long…sorry. I just want to share a few of my experiences with pdocs/therapy.

    Most of my therapists have been women since my MDD began in my late teens. I only had one good female therapist in all that time…I’m 43. My current pdoc is a man and it has been the best thing for me to work with a man, because I had/have so many father issues.

    Also, I had great success with CBT in the early stages of my depression (in my early twenties). I’d say both because my depression, though very severe at the time, was not entrenched like it is now. 20 plus years of depressive episodes, and near hypomania thrown in…someone should have referred me to a psychiatrist. Anyways, my belief about CBT is that it help mild/moderate depression and depression early on, but that it is not helpful for severe depression because when you are that depressed it is next to impossible to do the activities, set the goals , do the activities etc. that CBT requires.

    In the past 15 years I have tried CBT therapy numerous times and not only failed miserably at it, but left feeling it was my fault I could not succeed.

    My pdoc uses all kinds of therapy techniques with me. He isn’t stuck in one school of thought. For me that is very important and helpful. We do explore my past issues, because they “bleed” into my curent life; things I never dealt with etc. Personally I find many of the psychodynamic theories very helpful.

    I am especially interested in, and believe they speak perfectly to me, the theories of Existential Psychotherapy. Irvin Yalom has written an incredible textbook called, “Existential Psychotherapy. I have read it many times and it’s message of personal responsibility, search or meaning and purpose and learning what the life you want is, and building it have been very helpful to me. He also writes fiction that further explains his theories. I especiallly liked “Lying on the Couch”, and “When Neitzche Wept”.

    I really hope you are able to find the pdoc and the therapy that works for you. Please do not be afraid to try other pdocs. My only real suggestion (vs. what has helped me), is that you find someone who is willing and able to utilize the best ideas from all the schools of thought.

    Just one more thing…for me, having a more passive dr. vs. some of the therapists who told me what to do, has made ME make the decisions. It is after all my life and I need to make decisions my way. Honestly, my experience with psycodynamic and existential therapy, along with some CBT thrown in, has been a long, arduous and painful journey, but I am coming out the other side a person who is getting closer and closer to who I am supposed to be.
    Take care,

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